| NPI | 1376578120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: IL 036084957) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036-084957) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: IL 036-084957) | |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2021-04-26 |